阿皮克萨班用于预防亚临床心房动中风
Jeff S Healey1, Renato D Lopes1, Christopher B Granger1
1From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada; the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.); Amphia Ziekenhuis, Breda, the Netherlands (M.A.); Oslo University Hospital and the University of Oslo, Oslo (D.A.); the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy; St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom; J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.); the Medical University of South Carolina, Charleston (M.R.G.); Michigan State University, Lansing (J.I.); the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.); the University of Rochester, Rochester, NY (V.K.); Semmelweis University, Budapest, Hungary (V.K.); Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.); the University of Rennes, Rennes, France (P.M.); Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.); Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain; Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.); University Hospital Basel, University of Basel, Basel, Switzerland (C.S.); the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.); and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.).
与阿司匹林相比,阿皮克萨班在亚临床心房的患者中降低了中风风险. 然而,阿皮克萨班也增加了重大出血事件的风险,需要仔细考虑治疗的益处和风险.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 亚临床心房动 (SCAF) 是无症状的,并通过持续监测检测.
- SCAF显著增加中风风险 (2.5倍),但抗凝效益尚不清楚.
研究的目的:
- 评估阿皮克萨班与阿司匹林在SCAF患者中的疗效和安全性.
主要方法:
- 一个双盲,双模拟试验随机将4012名SCAF患者分配给阿皮克萨班或阿司匹林.
- 主要疗效结果:中风或全身血栓塞. 主要安全结果:严重出血.
主要成果:
- 阿皮克萨班降低了中风/全身血栓塞的风险 (0.78%vs1.24%每年患者;HR 0.63).
- 艾皮克萨班的重大出血风险较高 (1.71%vs0.94%每患者年;HR1.80).
结论:
- 在预防SCAF患者中风方面,阿皮克萨班比阿司匹林更有效.
- 阿皮克萨班的使用与严重出血的风险增加有关.
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